II. Types
- Finger tip (superficial Hand Infections)
- Deep Hand Infections
- Infected open Fracture (e.g. fifth Metacarpal Fracture)
- Suppurative Tenosynovitis
- Human Bite (due to clenched fist injury)
- Regional Infections
III. Differential Diagnosis: Non-infectious Causes of Hand Lesions
- Acute calcific Tendinitis
- Chronic Paronychia
- Hand Dermatitis
- Contact Dermatitis
- Dyshidrotic Eczema
- Foreign body skin reaction
- Inflammatory Arthritis
- Pyogenic Granuloma
IV. Management
- Treat for specific causes above
-
General measures
- See Cellulitis for general measures
- Tetanus Prophylaxis for open wounds
- Irrigate open wounds
- Incision and Drainage for abscesses
- Surgical Debridement for necrotic tissue within wound
- Rest and elevate the affected hand (reduces edema)
- Apply warm compresses to the affected hand (increases local Blood Flow and Antibiotic delivery)
- Splint in a position of function (decreases risk of flexion contractures)
- Open Fracture
- Emergent orthopedic Consultation
- Antibiotic coverage
- Start with First Generation Cephalosporin
- Add Aminoglycoside for contaminated wounds
- Add high dose Penicillin if Clostridium suspected